Yvan Brodeur’s family feared the worst when Quebec nursing homes went into lockdown at the start of the pandemic. Three months before, the 80-year-old nearly died when they couldn’t visit him during a flu outbreak at his long-term care facility. And then, when COVID-19 struck, once again family caregivers were kept away.
Despite the family’s polite but desperate pleas, Mr. Brodeur died six weeks later and his relatives believe that it was in large part because they couldn’t be there to make sure he was properly hydrated, a coroner’s inquest heard this week.
Coroner Géhane Kamel’s inquest is looking at the deaths in Quebec care homes during the first wave of the COVID-19 pandemic. This week it examined what happened to Mr. Brodeur, a resident at CHSLD René-Lévesque, a 224-bed long-term care facility in Longueuil, near Montreal.
During the first wave at CHSLD René-Lévesque, 114 health care workers and 118 residents became infected with the novel coronavirus, with 54 of them later dying.
Mr. Brodeur’s case happened at a public facility, underlining how staff shortage and other systemic shortcomings didn’t just afflict private homes. It also showed how a sweeping decision by the province to shut out family caregivers – in an effort to limit the virus’s spread – did more harm than good.
Family caregivers were traditionally a crutch for short-staffed personnel in nursing homes, helping them care for unco-operative residents suffering from dementia, the inquest heard.
“What happened in LTC homes is a national shame. ... This should be a serious wake-up call,” Mr. Brodeur’s wife, Micheline Guimond, wrote in a September, 2020, letter to chief coroner Pascale Descary that was filed as an exhibit.
“This catastrophe was predictable, even to a neophyte like me. ... My regular visits made me see that it would be a catastrophe without caregivers. When the Premier and the Health Minister say that it wasn’t a predictable situation I find it a total aberration.”
She knew what could happen if she and her children were locked out because they couldn’t visit Mr. Brodeur for two weeks in January, 2020, during a flu outbreak.
Mr. Brodeur, who had dementia and Parkinson’s disease, became lethargic and had excessive blood sodium, a sign of severe dehydration. The family insisted to get him hospitalized and he eventually got better. “He looked like he was dying. His chest was heaving, his eyes were hollow,” his daughter Amélie Brodeur testified.
When COVID-19 appeared last spring, the government of Premier François Legault on March 14 barred visitors, including caregivers, from entering nursing homes and hospitals.
Ms. Guimond immediately e-mailed the regional health authority, seeking permission to keep acting as a caregiver. She recalled the January episode when “unfortunately, the employees, perhaps because they ran out of time, didn’t give him the necessary care.”
She said she had been self-isolating so she was less likely to bring in the virus than workers who had to taken public transit.
No one at the LTC home answered her calls. Contacting a supervisor, she wrote, “I presume you have been very busy since you returned to work. I haven’t heard from you but I want to make sure my spouse is well.”
Ms. Brodeur testified that “when your father is vulnerable and you leave him there, you really don’t want to criticize the people who take care of him.”
The absence of caregivers during the pandemic made a big difference, one orderly testified.
“Sometimes we were just two [employees] trying to feed 16 people, it’s not easy,” said the orderly, whose name is under a publication ban. “… When the families were there I was very happy, it was a relief because I thought to myself, okay, at least these ones will be taken care of.”
A month after banning visitors, the government changed its mind. “We need arms,” Mr. Legault said in announcing he would allow a limited return to caregivers. At the time, 435 people had died and 1,250 health workers were missing.
However, many care homes still wouldn’t reopen their doors to relatives so, three weeks later, in early May, the government issued another directive putting the onus on LTC homes to justify in writing why they wouldn’t allow caregivers.
By then it was too late for Mr. Brodeur. He was hospitalized on April 24 and died five days later. Ms. Brodeur was able to visit during his final moments. “It’s not sad to die, it’s sad to die like that,” she said.
CHSLD René-Lévesque is in a suburb with a growing, aging population, the chief executive officer of the local health board, Louise Potvin, testified. Her organization is responsible for 16 care homes with 2,100 residents, 10,000 elderly people receiving home care services and 14,000 people in private retirement homes.
Despite increased government funding, staff shortage remains. “Long-term care is not as glamorous in Quebec as heart surgery or emergency care,” she said.
Despite her husband’s death, Ms. Guimond was grateful for the employees and she thanked the orderly who testified.
“You held the fort during the pandemic, I am very touched by what you did,” Ms. Guimond said, her voice breaking.
“Thank you, you’re making me cry,” the orderly replied. “You’re the only family I’ve spoken with because I’ve lost touch with all the others. Those people all died.”
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